Evidence-Based Treatments and Thoughts

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Evidence-Based Treatments and Thoughts

Post by Ailsa » Wed Feb 12, 2014 8:42 am

So, first let me say that there is controversy over the use of the term “evidence based.” What I am about to share are from an American Psychological Association (APA) journal called American Psychologist. The APA is the biggest professional psychological organization in the United States. It should also be noted that these therapy modalities were developed in the Veterans Affairs (VA) hospitals. And, if any of you have worked with the VA you will understand why I mentioned it. So, some things may be a little different for you depending on the country you live in. I hope this helps and I will share a few personal thoughts at the end.

The information below is from the following article: (2014, Karlin & Cross - From the laboratory to the therapy room: National dissemination and implementation of evidence paces psychotherapies in the U.S. Department of Veterans Affairs Health Care System)
Links, where available, are from Wikipedia or GoodTherapy.org.

Evidence Based Treatments
Cognitive Processing Therapy http://en.wikipedia.org/wiki/Cognitive_ ... ng_therapy
Prolonged Exposure Therapy http://en.wikipedia.org/wiki/Prolonged_Exposure_Therapy

Cognitive Behavioral Therapy for Depression http://www.goodtherapy.org/Cognitive_Be ... erapy.html
Acceptance and Commitment Therapy for Depression http://www.goodtherapy.org/Acceptance_C ... erapy.html
Interpersonal Psychotherapy http://www.goodtherapy.org/interpersona ... erapy.html

“Serious Mental Illness”
Behavioral Family Therapy
Multiple Family Group Therapy
Social Skills Training

The above “treatments” are based on a strong family unit/social support structure and have very little documentation outside of the VA system. This means that I couldn’t find a reputable link to what each modality entails.

Relationship Distress
Integrated Behavioral Couples Therapy

Cognitive Behavioral Therapy for Insomnia http://www.goodtherapy.org/Cognitive_Be ... erapy.html

Chronic Pain
Cognitive Behavioral Therapy for Chronic Pain http://www.goodtherapy.org/Cognitive_Be ... erapy.html

Motivation and Adherence

Motivational Interviewing http://en.wikipedia.org/wiki/Motivational_interviewing

Substance Abuse Disorders
Motivational Enhancement Therapy http://www.goodtherapy.org/motivational ... erapy.html
Contingency Management
Behavioral Couples Therapy
Cognitive Behavioral Therapy for Substance Use Disorders http://www.goodtherapy.org/Cognitive_Be ... erapy.html

Ailsa’s Thoughts
The above therapy modalities are what the VA says are “evidence-based” and “gold standard” treatments. They also have manuals that they have to follow for each modality. With that being said, they tend to be biased towards a cognitive behavioral approach, medical model, and tend to look down on anything that does not fit their ideal way of doing things.

It would be very useful to look into other therapy modalities so that you are an informed consumer of services. If you are considering a therapist please do yourself a huge favor and ask the therapist the following questions:

What is your training background?

PsyD and PhD Clinical Psychologist approach many topics from a very different view of the world then PdD Counseling Psychologists. Here is the general rule of thumb, Clinical means a more medical model of interaction and Counseling means a more holistic humanistic approach to therapy. There is some overlap, but it is more the exception and not the rule. Both Clinical and Counseling Psychologists should have graduated from an APA accredited institution and completed an APA accredited internship. As for licensing, most state licensing boards license Clinical and Counseling Psychologists as the same thing so it really comes down to style.

What does this mean for you? Bias Alert: This is my personal opinion, trans-people are less likely to run into barriers with Counseling Psychologists (though that does not mean bumps in the road don't exist) and are more likely to be able work through challenges from a holistic approach. If you are one who seeks to transition and the two therapist requirements are still in place, you will need a psychologist (read PhD or PsyD level practitioner) to write you a letter.

Finally, there are plenty of good master’s level therapists. However, I don’t know that world as well as the doctoral level one. These questions would be good for a masters level therapist as well. The things to look for as far as licensing go for masters level practitioners are Licensed Professional Counselors (LPC), Licensed Mental Health Counselors (LMHC), Licensed Marriage and Family Therapists (LMFT), and Licensed Clinical Social Workers (LCSW). Note the “license” and these will vary from state to state.

What is your theoretical orientation?
Training is one part of the equation and theoretical orientation is another. Theoretical orientation is how the psychologist approaches therapy. It is the foundation from which they build their therapeutic practice. Make sure you understand how a therapist operates; it is as important as their training.

For example, my theoretical orientation is an integration of Humanistic and Constructivist Theories. Humanistic Theory essentially means that I take an approach that the client is the expert regarding his or her life and Constructivist Theory in a nutshell means that we make meaning from our interactions with environment around us. All of the therapeutic modalities that I use in session are filtered through the lens of Person-Centered Therapy (the humanistic component). And, I also use Coherence Therapy (Constructivist Theory), Motivational Interviewing, and Acceptance and Commitment Therapy depending on the client and the situation.

Do you have any special certifications?
This is an indirect way of asking if a therapist is safe to work with. For instance, many US universities have instituted a program called “Safe Zone.” (Please Google Safe Zone to learn more.) It is a way of telling LGBT clients that they are in a safe place without having to say that it is a safe place. What you are looking for is any kind of certification that is LGBT related or something in their conversation that let’s you know that sharing your challenges with them will be respected and honored.

Take care my friends.


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Re: Evidence-Based Treatments and Thoughts

Post by Lindaj » Wed Feb 12, 2014 3:19 pm

Well done I am glad you broke the ice of this topic as you discussed with me
Live today for all it is worth for tomorrow may never come and if it does it will be today.

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